[Study of the kinetics of accumulation and distribution of the photosensitizer photoditazin in the oral mucosa in patients with lichen planus]

THE AIM OF THE STUDY

Was to explore the accumulation and distribution of the photosensitizer Photoditazine in the oral mucosa when applied to pathological lesions in patients with severe forms of lichen planus.

MATERIAL AND METHODS

A clinical and laboratory examination was carried out in 50 patients with severe forms of lichen planus (bullous and erosive-ulcerative) aged 18 to 70 years, including 6 men and 44 women. For autofluorescent imaging a LED device with a wavelength in the violet region of the spectrum (400±10 nm) was used. Quantitative registration of the kinetics of accumulation and distribution of the photosensitizer was carried out using the method of local fluorescence spectroscopy by measuring the fluorescence spectra.

RESULTS

The measurements were made before applying the photosensitizer, 10, 20 and 30 minutes after application. The study showed that in most patients with erosive-ulcerative and bullous forms of lichen planus, the accumulation of the photosensitizer in the lesions on the oral mucosa increased as the exposure time increased from 20 to 30 minutes. The fastest accumulation of the photosensitizer occurred in the areas of mucosal lesions with the most pronounced vascularization, namely, in the area of the tongue and the bottom of the oral cavity.

CONCLUSION

Using the method of local fluorescence spectroscopy, the kinetics of accumulation and destruction of photosensitizer in pathological areas of the oral mucosa was determined, and therefore the optimal time of laser exposure to the lesion was determined.

[Dental gel Cholisal at the stage of conservative treatment of inflammatory periodontal diseases]

PURPOSE OF THE STUDY

To study the effectiveness of using the drug Cholisal as part of the conservative treatment of chronic periodontitis.

MATERIAL AND METHODS

We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute phase with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of CGP, patients were divided into two groups of 50 people. In the main group, in addition to standard treatment, the dental gel Cholisal was used, and in the control group, therapy was standard. 10 days after professional hygiene, patients in both groups were examined and underwent an index assessment of the condition of periodontal tissues and adherence to treatment.

RESULTS

In patients of the control group, 10 days from the start of treatment, the depth of periodontal pockets in the control group decreased slightly from 4.7±0.28 mm to 4.2±0.21 mm (p=0.074), and the Green-Vermillion hygiene index decreased by 25.3±1.79% (p=0.041), Silnesse-Loe plaque index by 59.1±2.16% (p<0.001), PMA index by 51.5±1.92% (p<0.001) and Muhlemann-Cowell bleeding index by 42.2±1.75% (p<0.001). In the main group, the effectiveness of treatment of chronic periodontitis with conservative therapy using Cholisal was higher. There was a statistically significant decrease in the depth of periodontal pockets from 4.8±0.23 mm to 3.5±0.19 mm (p=0.043), the Green-Vermillion hygiene index decreased by 47.6±2.13% (p=0.0003), Silnesse-Loe plaque index by 78.2±3.05% (p<0.001), PMA index by 69.4±2.74% (p<0.001) and Muhlemann-Cowell bleeding index by 66.9±1.62% (p<0.001).

CONCLUSIONS

The use of the drug Cholisal in the conservative treatment of chronic periodontitis has shown convincing positive dynamics in both subjective and objective assessments, which suggests its effective use.

[Features of molecular genetic diagnosis of verrucous leukoplakia]

OBJECTIVE

To evaluate the initial molecular genetic signs of malignancy of verrucous leukoplakia (VL).

MATERIALS AND METHODS

The study of VL was carried out on biopsies of 21 patients with the diagnoses of verrucous hyperplasia (VH) (15 cases - 71.4%) and verrucous carcinoma (VC) (6 cases - 28.5%). Tissue antigens were determined using mouse monoclonal antibodies to the Ki-67 protein (MM1, Diagnostic Biosystems). Telomerase activity was determined using rabbit immunoglobulin (TRT, Abbiotec). The amplification of the TERC (Telomerase RNA Component) portion of the RNA of the third chromosome was studied by the FISH method.

RESULTS

In the studied groups, high cell proliferation and significant differences between HC and VC were revealed. The amplification of TERC by the FISH method made it possible to carry out differential diagnostics between VG and VC. According to the results of the study, the amplification of the TERC gene was detected in 100% in VC and in 20% in VG.

CONCLUSION

The FISH method makes it possible to detect VL malignancy at an early stage. Amplification of the TERC gene is characteristic of malignant transformation of epithelial cells in VC. In IG, as a rule, there was no amplification, which can serve as evidence of the benign nature of the pathology of COP.

[External cervical tooth root resorption]

External cervical tooth root resorption is one of the most aggressive types of pathological resorption. Due to the uncontrolled growth of resorptive tissue, irreversible loss of dentin and cement occurs. To date, there is no common position regarding the etiological factor and pathogenesis of invasive cervical resorption. The histological picture is similar to some fibro-bone lesions. The treatment outcome of the pathology is difficult to predict because elimination of the causative factor is often not sufficient for resorption arrest. Only the complete elimination of resorptive tissue helps to stop the process. The report describes a clinical case of a successful treatment of invasive cervical resorption of dental hard tissues.

[The use of photodynamic therapy in patients with severe forms of leukoplakia]

OBJECTIVE

The aim the study is to increase the effectiveness of the treatment of severe forms of leukoplakia with the use of photodynamic therapy.

MATERIAL AND METHODS

120 patients with severe forms of leukoplakia were examined. 30 patients were diagnosed with Cr and carcinoma in situ, and therefore they were excluded from the study. In 90 patients, the diagnosis was confirmed by histological and IHC studies. Before the use of photodynamic therapy, the degree of saturation of pathological foci with a photosensitizer was determined by the method of fluorescent diagnostics using the LED device «RFS-400».

RESULTS

As a result of treatment with photodynamic therapy using a 2nd generation photosensitizer («Photoditazine» 0.5% gel penetrator), a significant improvement in the epithelization of lesion elements was observed: in 92% of patients with verrucous leukoplakia and in 83% of patients with erosive leukoplakia.

CONCLUSION

The use of photodynamic therapy for the treatment of patients with complicated forms of leukoplakia is an effective method of treatment for this pathology.

[Experience of using bacteriophages in the complex treatment of children with aphthous stomatitis]

Aphthous stomatitis (AS) is one of the most common diseases of the oral mucosa in children. A significant role in the pathogenesis of AS is assigned to the infectious-allergic factor.

THE AIM

Of the work was to evaluate the clinical effectiveness of topical application of bacteriophages in the complex treatment of children with aphthous stomatitis.

MATERIALS AND METHODS

The main group included 30 children with AS aged 4 to 15 years. The control group consisted of 20 healthy children without AS and without concomitant somatic pathology at the age of 4 to 15 years. The effectiveness of the therapy was evaluated based on the results of repeated bacteriological examination of the oral microflora, conducted 1 month after phage treatment, as well as the dynamics of clinical manifestations: reduction in size or complete epithelization of defects.

RESULTS

The use of bacteriophage in the complex treatment of children with AS was accompanied by positive dynamics of clinical and laboratory parameters in all patients: a significant decrease in microbial contamination and the number of individual pathogenic microflora species against the background of normalization of local microbiocenosis in the oral cavity.

CONCLUSION

The obtained clinical and laboratory data allowed improving the scheme of complex treatment of AS in children by the use of bacteriophages.

[The creative legacy of Professor Gennady Vladimirovich Banchenko and the prospects for scientific research in the field of pathology of the oral mucosa (dedicated to the 85th anniversary of the birth of Professor G.V. Banchenko)]

G.V. Banchenko was born on July 11, 1936. After graduating from Moscow Medical Dentistry Institute in 1959, he worked in the N.N. Burdenko Main Military Clinical Hospital - first as a resident of the 13th sto- sion. N.N. Burdenko - first as a resident of the 13th stomatological department, therapist and then as maxillofacial surgeon.

[Optimization of the diagnosis of precancerous diseases of the oral mucosa and lips (Manganotti's abrasive precancerous cheilitis and erythroplakia)]

OBJECTIVE

To optimize the identification of precancerous diseases of the oral mucosa, such as Manganotti's abrasive precancerous cheilitis and erythroplakia of the oral mucosa using markers Ki-67 and keratin 15.

MATERIAL AND METHODS

The study group included 17 patients with Manganotti's abrasive precancerous cheilitis and 8 with erythroplakia of the oral mucosa. A histological analysis was carried out to scrutinize the biopsy material of the oral mucosa of the patients. Ki-67 protein and keratin 15 were used to assess the proliferative activity of epithelial cells and the severity of neoplasia. Results. Thirteen patients with Manganotti's cheilitis had dysplasia of varying degrees, and 4 had signs of malignancy. A high proliferative activity of the Ki-67 protein was found in the stratum basal and stratum spinosum of the epithelium. In 5 patients with erythroplakia, according to histological examination, grade 2-3 intraepithelial neoplasia was revealed and 3 patients had cancer in situ. The expression of keratin 15 in all patients with Manganotti's abrasive precancerous cheilitis and erythroplakia in the basal layer tended to decrease with an increase in the degree of dysplasia, however, the appearance of keratin 15 in the cytoplasm of cells located above the basal layer was discovered.

CONCLUSION

The use of Ki-67 protein and keratin 15 as immunohistochemical markers in the study of diseases such as Manganotti's abrasive precancerous cheilitis and erythroplakia of the oral mucosa makes it possible to identify the initial signs of malignancy more accurately in the epithelium.

[Manifestations of allergic reactions occurring at a dental appointment]

OBJECTIVE

To analyze the data of modern scientific literature to conduct a study on identifying the true allergic reaction at a dental appointment.

MATERIAL AND METHODS

The article is based on the study of materials from domestic and foreign research databases eLibrary, PubMed, Cochrane Database Systematic Reviews. The research period is 15 years.

RESULTS

Among dental materials, the most common allergens are local anesthetics, metal alloys, components of composite materials, latex.

CONCLUSION

If allergy is suspected, it is necessary to carefully collect an anamnesis and conduct a clinical examination of the patient with the involvement of specialist doctors, with the recommendation of skin tests and test subcutaneous provocation.

[Dental root resorption etiology, diagnosis and treatment]

The process of resorption of hard tooth tissues is associated with the activity of osteoclasts. However, the initiation of resorption can be caused by many factors acting separately or simultaneously. The paper presents the characteristics of pathological tooth resorption. The main etiological factors, pathogenesis, clinical manifestations, as well as treatment of various forms of tooth resorption are described.

[Epidemiology, etiology and pathogenesis of oral mucosa bullous lesions]

OBJECTIVE Based on the data available in modern literature, to conduct a study on the epidemiology, etiology and pathogenesis of bullous lesions of the oral mucosa (pemphigus vulgaris, pemphigoid bullosa, lichen ruber planus).

MATERIAL AND METHODS

The article is based on the study of materials of foreign and domestic research databases Pubmed and Elibrary. Used literature data over the past 15 years.

RESULTS

According to domestic and foreign studies, among dermatological diseases, the most frequently detected diseases are: lichen ruber planus, pemphigoid bullosa and pemphigus vulgaris. The initial signs of these diseases are often neglected, both in patients and doctors, which leads to irreversible changes and severe course of the pathological process. In this connection, the number of patients with these lesions of the oral mucosa increases every year in all countries of the world. Bullous lesions of the oral mucosa are inflammatory and destructive diseases characterized mainly by recurrent course, variety of clinical manifestations, resistance to various therapeutic drugs. The specific features of the course of these diseases are explained both by the anatomical and physiological features of the oral mucosa, and by the etiologic and pathogenetic mechanisms of development. Currently, autoimmune processes play a leading role in the genesis of diseases, developing in response to changes in the antigenic structure of epidermal and epithelial cells under the influence of various damaging agents.

CONCLUSION

Thanks to the study, it was found that currently there are no data confirming the presence of microbial contamination of the tissues of the oral mucosa in the pathology under study. Not enough information on the factors of the immune response, in particular, on proinflammatory cytokines in the tissues of the oral mucosa.

[Root canals dentinal wall structure after photodynamic exposure]

The aim of the study was to assess root canal dentinal walls structure after photodynamic exposure with the use of 0.5% photoditazine. A root canal dentin of 46 single root intact teeth removed for orthodontic indications was examined by scanning electron microscope JEOL JSM-6510 (Japan). Microphotographs of the root canal wall were obtained in the orifice, central and apical parts under×2000 magnification. It was found that photoactivation of 0.5% gel photoditazine by a light source, laser or diode, with a wavelength of 635-660 nm and a power of 150-200 mW is an effective technique for removing the smear layer of the root canal wall, which facilitates the maximum opening of the dentinal tubules to a depth of 2-3 μm. The best result (the maximum number of open dentinal tubules, the absence of a smear layer) is observed with 3 min photoditazine exposure and 2 min of laser exposure. The method can be proposed as an alternative supplement to the conventional root canals irrigation.

Photodynamic therapy in treatment of severe oral lichen planus

The aim of the study was to elaborate the rationale for the application of photodynamic therapy in complex treatment of patient with severe oral lichen planus. Complex clinical and laboratory examination and treatment was performed in 54 patients divided on 3 groups. Diagnosis of oral lichen planus was based on clinical, histological and immunohistochemical features. Group 1 received standard treatment, in the second group photodynamic therapy was conducted in addition to conventional treatment, patients in the third group received only photodynamic therapy. The study results proved photodynamic therapy to be useful tool in complex treatment of severe oral lichen planus.

[The epidemiological relationship of periodontitis, intestinal dysbiosis, atherogenic dyslipidemia and metabolic syndrome]

The study of risk factors for cardio-vascular continuum (CVC), the influence of the digestive tract endobiosis on lipid-carbohydrate metabolism and clinical status, a retrospective analysis of 1000 medical records of patients, suffering from various diseases of internal organs (Gastrointestinal tract, coronary heart disease, type 2 diabetes, obesity) in combination with periodontitis of varying severity, aged 20 to 55 years. A statistically significant relationship is directly proportional to the severity of inflammation of periodontal tissues with body mass index (BMI), especially pronounced in patients with a BMI ≥225 kg/m2 which is the "calling card" of the metabolic syndrome - clinical model polymorbidity.

[Optimization of complex treatment of patients with severe oral leukoplakia]

The aim of the study was to prove the rationale for antiviral therapy combined with surgical procedures for treatment of severe oral leukoplakia. Complex clinical and laboratory evaluation and treatment was performed in 56 patients divided in 2 groups. Control group was presented by 13 patients receiving dental treatment, local and systemic keratoplastic formulations. Main group involved 43 patients in which conventional treatment protocol was completed by antiviral therapy and surgical procedures. Leukoplakia diagnosis was based on clinical findings, histological and immunohistochemical studies as well as optic coherent tomography data. The obtained results evidently prove the necessity for including antiviral therapy and surgical procedures in treatment scheme of severe oral leukoplakia.

[Papillomavirus in the genesis of oral leukoplakia]

Immunohistochemical examination of the proliferative activity of cells was made investigating the expression of Ki-67 protein and the location of proteins associated with epithelial cell papillomavirus infection involving P16(INK4a) and HPV16 proteins in different cell areas of the intact mucosa, in leukoplakia with the signs of hyperplasia and dysplasia, and in squamous cell carcinoma. There was a positive correlation between the proliferative activity of cells in the parabasal cell areas and the expression of P16(INK4a) protein in oral leukoplakia with the signs of hyperplasia (r(s)=0.397; p=0.018). In oral leukoplakia with dysplastic changes, there was a positive correlation between the proliferation of cells in the parabasal and prickle cell layers and the location of HPV type 16 antigens (r(s)=0.515; p=0.041 and r(s)=0.651; p=0.006). Detection of papillomavirus infection in leukoplakia can solve not only the problems with its genesis, but this is also a morphological basis for the effective prevention and treatment of this common oral mucosal disease.

[Methods of complex diagnostics of oral leukoplakia]

The problem of diagnostic of various forms of leukoplakia of the oral mucosa is reviewed IT is introduced a set of methods for diagnosis of the disease, including a clinical check up, evaluation of the data of optical coherence tomography, classical histological and immunohistochemical study to determine the neoplastic cell transformation of oral mucosa in the early stages of its development.

[Likopid in complex treatment of oral dysbiosis]

The aim of the study was to assess likopid effectiveness in complex treatment of oral dysbiosis. The study included 76 patients: 23 patients receiving antifungal and antimicrobial treatment, eubiotics and bacteriophages and 53 patients in which the above mentioned therapy was combined with licopid as immunocorrective agent. Laser flow cytometry was used to examine oral fluid bacteriostatic properties. The results of the study confirm licopid to be useful for complex treatment of oral dysbiosis.

[Immunomorphology of recurrent aphthous stomatitis]

The immunohistochemical investigation of native epithelium and recurrent aphthous stomatitis has been carried out. The A, M, G Igs, CD3 fragment of the compliment, and CD16 lymphocytes in the zone of gidropic changes and necrosis of the oral mucosa were founded The distribution of Igs, CD3 fragment of the compliment and natural killers in the same zone - prickle laminated keratinizing epithelium could be signs of immunocomplex and T-cell-dependent mechanisms of ceracinocytes dies. The results of our research prove the theory of immunotoxicity priority in oral mucosa in cases of recurrent aphthosus stomatitis.

[Improving diagnostics of leukoplakia]

The study included 32 patients (among them 20 patients with simple and 12 with verrucous leukoplakia) and presents both classic and advanced diagnostic methods for this disease: clinical examination, histological and immunohistochemical studies. The latter allows revealing neoplastic transformation of the oral mucosa.

[Effects of immunomodulating therapy on immune status and the disease course in patients with relapsing herpetic stomatitis]

Clinical and immunological efficiency of leukinferone in combination with polyoxidonium (immunomodulator) was studied in patients with relapsing herpetic stomatitis (RHS). The levels of alpha- and gamma-IFN were decreased, levels of IgM, IgG, and IgE were increased, active oxygen forms were actively produced, and the count of CD8(+)-cells was increased in patients with RHS. Treatment with polyoxidonium and leukinferone led to an increase of the blood levels of alpha- and gamma-IFN, decrease of IgM, IgG, and IgE levels, normalization of phagocytosis, and decrease of CD8(+)-cell count. The treatment had a pronounced clinical effect in patients with RHS of any severity, which indicates the efficiency of these drugs in combined therapy of patients with RHS.

[Role of microflora in diseases of the buccal mucosa]

The role of microflora was studied in patients with diseases of the buccal mucosa (aphthous stomatitis, lichen planus, leukoplasia, desquamative glossitis, etc.). Quantitative and qualitative composition of the microflora and its sensitivity to antibiotics, antifungal agents, and bacteriophages were studied. The following changes in the microflora were distinguished: dysbiotic shift, dysbacteriosis of the I-II, III, and IV degree. Microbiological status of patients with diseases of the buccal mucosa is essential for the course, outcome, and prognosis of the underlying diseases.

[Immunomorphological characteristics of lichen planus of oral mucosa]

Immunomorphological studies of lichen planus of the oral mucosa were carried out using a wide spectrum of monoclonal antibodies. Antigenic composition of epithelial cells, lymphocyte subpopulations maintaining destructive processes in the epithelium in various clinical forms of this disease were studied. The study confirmed immunologically-mediated mechanisms of pathogenesis, leading to destructive processes in the epithelium in lichen planus of the oral mucosa, which should be taken into consideration in combined therapy of this disease.

[A method for using Stokos, a new generation of laser surgical apparatus, for treating diseases of the periodontium and oral mucosa in a large-volume outpatient setting]

Presents the design, technical characteristics (wave length 10.6 microns, power 5 W, continuous regimen) and methods of use of a new generation laser device ALSH-5 Plasma-R "Stokos", used for treating oral diseases (periodontal and oral mucosa diseases, odontogenic inflammations, reconstructive and plastic operations, etc.).

[The new-generation laser surgical apparatus Doktor in the combined treatment of stomatological disease in an outpatient setting]

Presents the design, technological characteristics (wavelength 10.6 mu cm, power up to 7 W, permanent mode) of a new-generation surgical laser Doktor and its use in the treatment of dental and maxillofacial diseases (diseases of the periodontium and buccal mucosa, pericoronitis, trophic ulcers, retention cysts, furuncles and carbuncles of the skin of the neck and face, odontogenic inflammatory processes, injuries, tumors) and in reconstructive, plastic, and cosmetologic surgery.

[The prevalence of diseases of the oral mucosa in workers in the cotton-processing industry]

The prevalence [correction of incidence] of diseases of the buccal mucosa is assessed from records on dental status of 494 subjects engaged in cotton industry. A high prevalence [correction of incidence] of oral diseases is revealed. Candidiasis of the oral cavity and diseases of the lips are referred to occupational in this category of patients.

[A clinico-laboratory validation of the combined therapy of lichen ruber planus of the oral mucosa]

Fifty-two patients with lichen planus were examined over the course of disease using clinical, microbiological, and histological methods. Treatment protocols aimed at normalization of microbiocenosis have been developed, based on the detected microbiological and histological changes.

[The laser therapy of diseases of the periodontium and oral mucosa]

Authors' methods (patented and certified) of complex (conservative and surgical) treatment of periodontal and oral mucosal diseases using new-generation laser devices (physiotherapeutic and surgical) have been tested on 588 patients. Results of the treatment are reviewed.

[T-activin in the treatment of patients with recurrent aphthous stomatitis]

The authors sum up the experience gained in tactivin therapy of patients with recurrent aphthous stomatitis and analyze the effects of this drug on the patients' cellular and humoral immunity. Thirty patients with various forms of the condition were subcutaneously injected tactivin in a dose of 40 micrograms for 10 days. Biochemical parameters were virtually unchanged after therapy, whereas the immunity parameters evidenced essential shifts in humoral and cellular immunity. Clinical and laboratory data indicate a sufficiently high immunocorrective effect of tactivin in therapy of patients with recurrent aphthous stomatitis.

[Immunosuppressive therapy and the reaction of the minor salivary glands in the oral mucosa]

Clinical changes in oral mucosa minor salivary glands were examined in 30 patients with grave diabetes mellitus treated by transplantation of pancreatic islet cells without immunosuppressant therapy and in 35 patients suffering from chronic renal failure 18 of these operated on for transplantation of an allogenic kidney with immunosuppressant therapy. Clinical condition and function of the minor salivary glands were assessed according to a scheme developed by the authors with consideration for clinical signs: edemas, hyperemia, hyperplasia, retention, and destruction. Morphologic examinations were carried out in various periods after transplantation.